Volume 19 Issue 1
Jan.  2021
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XU Qian-qian, LIU Bin-bin, CHEN Xue-xiang, SHEN Huai-yun. Analysis of preoperative risk factors of severe neonatal meconium aspiration syndrome[J]. Chinese Journal of General Practice, 2021, 19(1): 31-34. doi: 10.16766/j.cnki.issn.1674-4152.001722
Citation: XU Qian-qian, LIU Bin-bin, CHEN Xue-xiang, SHEN Huai-yun. Analysis of preoperative risk factors of severe neonatal meconium aspiration syndrome[J]. Chinese Journal of General Practice, 2021, 19(1): 31-34. doi: 10.16766/j.cnki.issn.1674-4152.001722
shu

Analysis of preoperative risk factors of severe neonatal meconium aspiration syndrome

doi: 10.16766/j.cnki.issn.1674-4152.001722

  • Department of Pediatric, First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 2016QKO44

  • Received Date: 2020-07-12
    Available Online: 2022-02-19
    Abstract
  •   Objective  To explore the risk factors affecting the prognosis of children with severe meconium inhalation syndrome (MAS), analyse the predictive value of these factors, and improve the clinical treatment level of MAS.   Methods  The clinical data of 77 patients with severe MAS treated by mechanical ventilation from January 2014 to December 2019 were retrospectively analysed. According to the treatment results, the patients were divided into successful ventilation group and failure ventilation group. The general data, arterial blood gas analysis and their complications were compared between the two groups. Receiver characteristic (ROC) curve and stepwise logistic regression were used to analyse the statistically significant observation indexes.   Results  (1) The incidence of intrauterine distress, persistent pulmonary hypertension (PPHN) and multiple organ dysfunction (MODS) in the failure ventilation group was 66.7%, 41.7% and 66.7%, respectively, which were higher than those in the successful ventilation group (41.5%, 5.7% and 22.6%). The Apgar score, pH value, arterial partial pressure of oxygen (PaO2) and buffer excess (BE) in the failure ventilation group were significantly lower than those in the successful ventilation group. The difference was statistically significant (all P < 0.05). (2) Multivariate logistic regression analysis showed that PaO2, BE value, PPHN and MODS were independent risk factors of mechanical ventilation in the treatment of MAS. (3) ROC curve analysis showed that the BE value of -8.5 was the suitable boundary point to predict MAS prognosis, and the sensitivity and specificity were 94.3% and 58.3%, respectively; its PaO2 was 40.5 mm Hg, which was the best boundary point to predict prognosis, and the sensitivity and specificity were 79.2% and 58.3%, respectively.   Conclusion  PaO2 BE values and combined PPHN and MODS are the independent risk factors affecting the prognosis of MAS after mechanical ventilation. BE values and PaO2 can predict the prognosis of children with MAS, and early and timely prevention and treatment of these risk factors can reduce the mortality of severe MAS.

     

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